Nursing Elites

1. After the nurse has finished teaching a patient who has a new prescription for exenatide (Byetta), which patient statement indicates that the teaching has been effective?

• A. �I may feel hungrier than usual when I take this medicine.�
• B. �I will not need to worry about hypoglycemia with the Byetta.�
• C. �I should take my daily aspirin at least an hour before the Byetta.�
• D. �I will take the pill at the same time I eat breakfast in the morning.�

Correct answer: C

Rationale:

2. A middle adult client tells the nurse, 'I feel so useless now that my children do not need me anymore.' Which of the following responses should the nurse make?

• A. Validate the client's feelings by saying, 'People in middle adulthood often find satisfaction in nurturing and guiding young people.'
• B. Encourage the client to explore the reasons behind feeling useless.
• C. Reassure the client by saying, 'You should be proud that your children are becoming independent.'
• D. Provide information by saying, 'Most people are happy when their children grow up and leave home.'

Correct answer: A

Rationale: The correct response is to validate the client's feelings by acknowledging that individuals in middle adulthood often derive satisfaction from nurturing and guiding young people. This response shows empathy and understanding towards the client's emotions. Choice B is incorrect because it may come across as dismissive of the client's feelings. Choice C is incorrect as it does not address the client's emotional state and could be perceived as minimizing their concerns. Choice D is incorrect as it generalizes feelings and may not be applicable to the client's specific situation.

3. When should the nurse initiate discharge planning for a client experiencing an exacerbation of heart failure?

• A. During the admission process
• B. As soon as the client's condition is stable
• C. After consulting with the client's family
• D. During the initial team conference

Correct answer: B

Rationale: The correct time for the nurse to initiate discharge planning for a client experiencing an exacerbation of heart failure is as soon as the client's condition is stable. Discharge planning should begin early to ensure a smooth transition and continuity of care. While involving the client's family in the planning process is crucial, the primary focus should be on starting the preparations for discharge once the client's immediate health concerns are addressed and their condition is stable. Waiting for a team conference or after consulting with the family may delay the planning process, which is not ideal in ensuring a timely and effective discharge plan.

4. An unresponsive patient with type 2 diabetes is brought to the emergency department and diagnosed with hyperosmolar hyperglycemic syndrome (HHS). The nurse will anticipate the need to

• A. give a bolus of 50% dextrose.
• B. insert a large-bore IV catheter.
• C. initiate oxygen via nasal cannula.
• D. administer glargine (Lantus) insulin.

Correct answer: B

Rationale: In a patient with hyperosmolar hyperglycemic syndrome (HHS), severe dehydration and electrolyte imbalances are common. To address these issues, the priority intervention is to insert a large-bore IV catheter for fluid resuscitation and electrolyte replacement. Giving a bolus of 50% dextrose would worsen the hyperglycemia. Initiating oxygen via nasal cannula may be beneficial for respiratory support but is not the priority in this scenario. Administering glargine (Lantus) insulin is not the initial treatment for HHS as it does not address the underlying severe dehydration and electrolyte imbalances.

5. What is the primary focus of a patient-centered care model?

• A. Cost reduction
• B. Healthcare provider satisfaction
• C. Patient satisfaction
• D. Quality assurance

Correct answer: C

Rationale: The primary focus of a patient-centered care model is on patient satisfaction. This approach emphasizes providing care that is personalized to meet the unique needs and preferences of each patient, fostering a collaborative and respectful partnership between healthcare providers and patients to achieve better health outcomes. While cost reduction (choice A) can be a byproduct of improved outcomes, it is not the primary focus. Healthcare provider satisfaction (choice B) is important but not the primary focus in patient-centered care. Quality assurance (choice D) is crucial but is secondary to patient satisfaction in a patient-centered care model.

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